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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604561
Report Date: 12/30/2024
Date Signed: 12/30/2024 01:15:56 PM

Document Has Been Signed on 12/30/2024 01:15 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:GENTLE HEARTS CHULA VISTAFACILITY NUMBER:
374604561
ADMINISTRATOR/
DIRECTOR:		ARIDA, JULLIAFACILITY TYPE:
740
ADDRESS:852 CREST DRIVETELEPHONE:
(619) 650-4688
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 6CENSUS: 4DATE:
12/30/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Jullia AridaTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA), Ramon Serrano, conducted an unannounced collateral visit as a follow-up for an unrelated complaint investigation for another facility. LPA was allowed entry by Administrator Jullia Arida and discussed the purpose of the visit.

During the visit, LPA interacted with staff and obtained facility records.

An exit interview was conducted with Jullia Arida and copy of this report along with Licensee Rights (LIC 9058 3/22) was provided to Jullia Arida whose signature below verifies receipt of these rights.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE: DATE: 12/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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